Aetna negotiated rates in Vermont
How Aetna's Vermont rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Vermont at a glance
What the data shows
Aetna ranks 4th of 4 payers in Vermont with a rate index of 74 (100 = the Vermont market median), across 56 procedure codes.
Aetna has the highest median for only 0% of codes in Vermont; UnitedHealthcare leads with an index of 142 in the files analyzed.
Aetna's Vermont rates sit 6% below its own national level, the 35th highest of its 51 states.
Largest premium over the Vermont market: CPT 70551 (Mri brain stem w/o dye) at 100% of market; largest discount: CPT 45385 (Colonoscopy w/lesion removal) at 47%.
How the four payers compare in Vermont
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 142 | 1 | 79% | 279 | |
| Cigna | 109 | 2 | 18% | 302 | |
| Blue Cross Blue Shield | 89 | 3 | 4% | 312 | |
| Aetna | 74 | 4 | 0% | 279 |
Where Aetna pays most and least against the Vermont market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 70551 Mri brain stem w/o dye | $394 | $394 | +0% | 43 |
| 72141 Mri neck spine w/o dye | $394 | $394 | +0% | 43 |
| 73721 Mri jnt of lwr extre w/o dye | $394 | $400 | -2% | 51 |
| 73221 Mri joint upr extrem w/o dye | $394 | $401 | -2% | 51 |
| 72148 Mri lumbar spine w/o dye | $394 | $410 | -4% | 50 |
| 93970 Extremity study | $234 | $258 | -9% | 56 |
| 93971 Extremity study | $149 | $167 | -11% | 43 |
| 74177 Ct abd & pelvis w/contrast | $410 | $461 | -11% | 43 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 45385 Colonoscopy w/lesion removal | $346 | $733 | -53% | 24 |
| 93000 Electrocardiogram complete | $18 | $30 | -42% | 117 |
| 71275 Ct angiography chest | $334 | $562 | -41% | 43 |
| 20610 Drain/inj joint/bursa w/o us | $56 | $92 | -39% | 123 |
| 99490 Chrnc care mgmt staff 1st 20 | $41 | $64 | -36% | 16 |
| 93306 Tte w/doppler complete | $247 | $388 | -36% | 29 |
| 88305 Tissue exam by pathologist | $57 | $90 | -36% | 19 |
| 77080 Dxa bone density axial | $39 | $60 | -35% | 42 |
Where Aetna pays above and below its national level
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 306 | 211 | |
| Idaho | 152 | 491 | |
| Washington | 142 | 708 | |
| Mississippi | 138 | 608 | |
| Montana | 136 | 80 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Indiana | 80 | 698 | |
| South Dakota | 82 | 147 | |
| Florida | 82 | 758 | |
| Minnesota | 84 | 774 | |
| North Dakota | 85 | 211 |
Frequently asked questions
Does Aetna pay more or less than the other payers in Vermont?
Aetna ranks 4th of 4 in Vermont with an index of 74. It is highest on 0% of codes.
Are Aetna's Vermont rates above or below its national level?
About 6% below.
Which procedure does Aetna pay most above market in Vermont?
CPT 70551 (Mri brain stem w/o dye), at 100% of the Vermont median.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your Aetna contract at market in Vermont?
Compare your negotiated rates for these codes with Vermont medians for each payer.